Adenoid cystic carcinoma involving paranasal sinus
65 year old gentleman presented with watering from left eye since 5 months and swelling over left side of nose since 1 month.
CT paranasal sinuses
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CT scan revealed a heterogeneously enhancing infiltrative lesion occupying the left maxillary sinus extending into the middle meatus. The lesion is eroding the walls of the sinus and breach is seen in the roof and floor of the maxillary sinus. However no evidence of any intra orbital or skull base extension was seen.
Clinical examination revealed a reddish mass in left middle meatus with left inferior turbinate slightly pushed medially. The mass was soft in consistency, smooth surface with no bony region underneath.
Nasal endoscopy and biopsy was done. Histopathology report came positive for adenoid cystic carcinoma.
Adenoid cystic carcinoma, that is , malignancy of minor salivary glands, most commonly affects the maxillary sinus among all the paranasal sinuses. It tends to recur locally with 'skip lesion' neural involvement.
Wild local excision is key to management.
- Ko YH, Lee MA, Hong YS et-al. Prognostic factors affecting the clinical outcome of adenoid cystic carcinoma of the head and neck. Jpn. J. Clin. Oncol. 2007;37 (11): 805-11. Pubmed citation